The profession of psychotherapy is pursued by a plethora of specialists, including psychiatrists, psychologists, clinical social workers, marriage and family therapists, and counselors of various derivations. And theories about what goes wrong with humans -- and why -- are even more numerous than the professions that practice the treatment of such problems.

Until now the mainstream theories have been, in my opinion, necessarily incomplete, mainly because they typically approach human nature as though it has no meaningful past (and therefore no real connection to the world around us), and inherent psychological processes as though they can be simply and straightforwardly reworked if they seem problematic (with of course the help of a therapist).

Genes on the Couch is a collection of self-contained but well-matched chapters that place human nature in a much more salient and meaningful context -- that of human evolution. Contributors include such internationally recognized academics and theorists as Paul Gilbert (UK), Nicholas Allen (Australia), Kent Bailey (USA), Michael McGuire (USA), Alfonso Troisi (Italy), and Anthony Stevens (UK).

The chapters cover an assortment of topics, but share the common theme of connecting some aspect of psychology or psychopathology to evolutionary forces and evolved adaptations. For example, several authors address the functions of shame and guilt, the importance of social relationships and social intelligence to adequate psychological functioning, and the evolved (natural) tendency toward rejection-avoidance and status seeking.

In general, psychopathology might be said to be the result of natural but problematic responses to social or socio-environmental situations. "Try as we might to be rational and reasonable in facing our personal, social and ecological problems, our evolved nature can overrule common sense" (p. 4). Further, emotional responses can actually change the physiological functioning of the body, e.g., depressed serotonin levels are correlated with depressed mood (p. 5).

One of the more important introductory points made by the editors is that we are designed to serve distal causes but, as people, we are motivated by our own proximal causes. The flexibility built into our minds and bodies has made us a wildly successful species, in evolutionary terms, but this same flexibility allows misdirected responses to occur in individuals (and groups). " [G]enes are the fundamental building blocks of life and . . . shape and (distally) predispose organisms to do certain things. But it is these proximal 'things' in a single individual's life that tells us most about normality and abnormality, joy and sadness, and relief from suffering" (p. 8).

Why, when it comes down to us as individuals, should we suffer depression, anxiety, and all the other host of emotional difficulties common in our species? Why should we struggle with love, social status, peer relations, and the more abstract but powerful drives toward "success"? If evolution had merely relied on reproductive success - - the numbers of surviving offspring and linear descendants - - to motivate us, why do humans seek so many different goals, and why are we so prone to unhappiness when these goals are thwarted? "[T]o achieve the ultimate goal of enhancing one's own reproductive success, a person must correctly execute a variety of adaptive behaviours including identifying, selecting and acquiring a mate, accurately interpreting his or her need and desires, and arousing his or her sexual interest. Each of these activities is a short-term goal that may be primarily rewarding [italics added], not simply secondarily rewarding because of its contiguous relationship to the ultimate [distal] goal" (p. 29).

Nature has provided us with an inner compass of sorts: when the achievement of primary (proximate) goals is frustrated, or our behaviors are maladapted or misdirected and don't appropriately serve such goals, we suffer corrective psychological distress. (However, this hypothesis may not adequately address all the functions of emotional distress. For example, just as a burned finger continues to hurt long after the damage has been done, psychological reactions to loss of status may drag us down into seemingly non-productive depression. Theorists have devised various hypotheses to explain this process, but these won't be covered in the current review.)

The "mainstream" theories of Jung and Freud, and the practical ideas and techniques of cognitive-behavioral therapies, are clearly shown in this book to be compatible with evolutionary theory as it is applied to human psychology.

For example, a psychoanalytically-oriented contributor (Daniel Kriegman of the Massachusetts Institute for Psychoanalysis) notes that an understanding of evolutionary psychology can help correct the tendency in the analytic process for the analyst to indoctrinate patients with their own core beliefs and biases. "The evolutionary perspective can help to correct this detrimental bias .... the evolutionary psychoanalyst/psychotherapist must struggle -- often against his or her own natural impulses -- to help patients find, define, uncover, and develop their own unique configurations of interests, abilities, talents, and beliefs" (p. 87-88).

Anthony Stevens, who has written extensively on Jungian therapy, notes that "In practice, the Jungian analyst, like the evolutionary psychiatrist, looks beyond the personal predicament of the patient and relates it to the story of humankind . . . . This perhaps is the most important conceptual contribution that evolutionary psychotherapy has to make: it grants an expanded view of the self" (p. 104).

Representing the cognitive approach, Nicholas Allen and Paul Gilbert observe, "Unlike standard cognitive therapy, we suggest it is important to consider the (possible) adaptive (strategic) significance of certain types of beliefs, and not view them as simply errors in reasoning" (p. 164).

This is just a small sampling of the excellent material found in this collection. The writers are uniformly facile in presenting their positions, and the writing is therefore a pleasure to read. There is much here from which therapists, researchers, clients and potential clients will benefit, and the book is heartily recommended.

Keith Harris, PhD, is a clinical psychologist and supervisor of Victor Valley Behavioral Health Center in San Bernardino county, California. His interests include clinical supervision, the empirical basis for psychotherapy research (and its design), human decision-making processes, and the shaping of human nature by evolutionary forces.

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